Arrhythmia

Summary/Definition

Heart rhythm arrhythmias refer to various abnormal heart rhythms that are usually described by two general terms, namely “irregular heart rate” and “frequent rhythm” (sinus tachycardia), or “less frequent rhythm” (sinus bradycardia). In this condition, a heart rate irregularity is noted in which the heart rate increases to 100 or more beats per minute in sinus tachycardia, or decreases to 60 or fewer beats per minute in sinus bradycardia. The Arrhythmias can be divided into supraventricular tachycardia, which is caused by abnormalities at the atrioventricular junction (atrial-ventricular junction), and right atrial arrhythmias and ventricular tachycardia, which occur in the ventricle of the heart. Tachycardia can occur in the ventricle of the heart or atrium and is divided into two main types: supraventricular tachycardia (supraventricular tachycardia) and ventricular tachycardia (ventricular tachycardia). Bradycardia can be divided into two types: sinus node dysfunction and complete atrial-ventricular block. The Arrhythmias can also be divided into the following types: sinus arrhythmias (normal sinus rhythm), primary pacemaker dysfunction (sinus node dysfunction); ventricular arrhythmias (e.g., poststroke depression) or secondary pacemaker dysfunction (atrial-ventricular node dysfunction); and atrial arrhythmias or tertiary pacemaker dysfunction (sinus-atrial node dysfunction) (in cor. variant Mixed disability is the occurrence of pigmented gallstones). According to the mechanism of arrhythmias, there are paroxysmal supraventricular tachycardia (paroxysmal supraventricular tachycardia) and ventricular extrasystole (ventricular arrhythmia), defined by the area of occurrence. As a result of this classification, the methods of diagnosis and treatment are changing, as each type of arrhythmia requires an individualized approach.

Symptoms

The symptoms can manifest themselves in different ways in different people, including cases where they are completely absent and cases of acute symptoms that are associated with structural abnormalities present in a particular individual. These symptoms can include palpitations (rapid heartbeat), changes in pulse rate, dizziness, brief loss of consciousness, fatigue, chest pain, chest discomfort, difficulty breathing, and even sudden death.

Diagnostics

The diagnosis of physiological cardiac rhythm disturbances is made based on data obtained from chest auscultation (listening) and blood pressure measurements using a sphygmomanometer, as well as other general examinations. Consultation with the patient and collecting data about symptoms, including from the history in the patient’s medical record, is also important. Optional diagnostic methods include electrocardiography (ECG) and daily ECG monitoring (Holter monitoring), EP heart test, echocardiography, as well as thyroid function tests and other procedures. Holter monitoring (Holter daily ECG monitoring) is a continuous recording of the patient’s heart rhythms for 24 hours using a portable ECG device. EP heart test involves measuring the electrical activity of the heart using a thin catheter with electrodes inserted into the heart cavity through the blood vessels of the arms and legs. This study allows you to record and study the heart’s response to direct electrical stimulation in different areas of the heart.

Treatment and course of the disease

The treatment of Arrhythmias is carried out in the presence of symptoms that indicate the possibility of sudden death. In the treatment of Arrhythmias, possible causes should not be neglected. Effective treatment can be achieved in combination with therapy for the causative diseases and restoration of left atrial function. Medication treatment includes first-class antiarrhythmic agents, which prevent arrhythmias and stabilize cardiac muscle myocytes; second-group antiarrhythmic agents, β-blockers, which reduce the risk of arrhythmias by blocking cardiac β-synthroid neuroreceptor receptors; antiarrhythmic drugs of the third group, which reduce the risk of arrhythmias by widening the action potential curve of the heart, and antiarrhythmic drugs of the fourth class – calcium blockers, which reduce the risk of arrhythmias by blocking calcium channels in myocytes of the heart muscle. Also used are foxglove drugs, which prolong the refractory phase of heart tissue and conduction velocity to reduce the risk of arrhythmias. Among the non-medication methods of treatment include the use of pacemakers, electrical pulse therapy, radiofrequency ablation and others. In some cases, surgical intervention is performed, in which the operated areas that contribute to arrhythmias are removed. This is recommended for patients who cannot tolerate drug treatment and do not respond to antiarrhythmic drugs, pacemakers, radiofrequency ablation and other treatment methods.